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30 is too young to be dx with COPD could it be alpha 1-antitrypsin defi...
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30 is too young to be dx with COPD could it be alpha 1-antitrypsin deficiency?

I am 30 years old. I have been having shortness of breath and difficulty with mild/moderate activity, since I had the bird flu a couple of winters ago.

I am a smoker. I have smoked since I was 16 years old (14 yrs total). I started as a half a pack smoker, then a pack a day smoker and every 3-5 years or so I would jump up by half a pack. I had recently jumped to 2 packs a day.
I went to the doctor who performed a lung function test (70 or 80% or normal), X-rays (normal), and the ABG showed I had respiratory alkalosis (high levels of CO2 CO1 and bicarbonate)
The doctor summed it up by saying that I was essentially running at 70% oxygen.

I have since had 2 lung infections: My doctors answer was I have COPD.
I accept this diagnosis and I am seeking treatment to quit smoking—I started taking wellbutrin to help me with it and now I am just waiting for the medication to get into my system, before I try and stop. I have my quit date set and a plan in place to facilitate my success.

My question has to do with how young I have been diagnosed. I am only 30 years old. I had a diagnosis of emphysema at 29—by 30 COPD. I am not a super heavy smoker and I did not start exceptionally young. One of the first things I noticed in my research to learn more about COPD, is that people who have a diagnosis of COPD at such an early age commonly have Alpha 1-antitrypsin deficiency--whether they are smokers or not. Is that something I should be considering? Should I ask about being tested for this? I know without this protein--my lungs are more likely to become more damaged, because the inflammation process has trouble turning off, which makes my lungs more susceptible to damage from viruses and the development of COPD, which could also explain why my symptoms suddenly began to be debilitating after I had a respiratory flu.
I accept that I have COPD, but it is hard to swallow that I have this diagnosis at such a young age
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The diagnosis of COPD at age 30 must be very disturbing to you and, if the diagnosis is correct, highly suggestive of alpha 1 anti-trypsin deficiency.  However, non alpha-1 COPD can occur in persons with a strong family history of COPD/emphysema – so-called “clustering.”  The question can easily be resolved by a measurement of your  blood alpha-1 level.  Depending on the result of that test,  and the degree of respiratory impairment on pulmonary function testing, you could well be a candidate alpha-1 replacement therapy.  

That your “lung function test” was reported as “(70 or 80% or normal)” may be good news to the extent that such values, although abnormal, suggest that you still have significant lung function that may yet be relatively preserved, should you succeed with smoking cessation, without delay.  What you describe about the ABG’s suggests that your reduced blood oxygen  level is at least in part due to smoking related, significantly elevated blood carbon monoxide (CO) levels rather to smoke-damaged lungs.  Your interpretation of the sequence of events, dating from the bird flu infection is on target.

You are at a critical juncture where actions taken now may markedly enhance lung preservation for the rest of your life.  I suggest that you and your doctor request consultation with a Pulmonologist (lung specialist) for his/her assistance with both diagnosis and treatment.  Should you want to consider consultation at a nationally renowned COPD center, I would suggest either National Jewish Health (my institution) in Denver, CO. or the University of Pittsburgh in Pittsburgh, PA.   If that is not feasible you might want to seek consultation at the nearest academic medical center as most of these centers have physicians with expertise in COPD.

You might also want to visit the Alpha-1 Association website at:  http://www.alpha1.org/whatisalpha1/a1lungdisease.php  or The Alpha-1 Foundation at:  http://alpha-1foundation.org/

Good luck
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